Cell Phone Text Technology Helps Promote Health in Senegal

A pilot project in rural Senegal uses text messaging to remind women of upcoming doctor’s appointments and local health meetings.

Health reminders

The sound of a text message, recognizable the world over, but in a small village tucked away down the sandy back-roads of Senegal, a few short beeps can be vital reminders. For mothers living in and around the Mbosse, receiving an SMS (cellphone small message service, text) from their doctor’s helps keep themselves, and their babies, alive and healthy.

At the Mbosse health clinic, a hundred kilometers northeast of Dakar, villagers are gathered from more than a dozen nearby communities. On one side of the courtyard are the men. They sit on white plastic chairs in the sand and under the shade of sprawling tents. Off to the side, three young kids put on face paint and costumes in preparation for a skit on malaria prevention.

Next to them, on colorful woven mats, is a group of mothers. They balance babies on their laps and spoon-feed a grainy mixture of dried fish, millet, tomato and peanuts into their tiny mouths. In a corner, four young women sit around a board game called "safe motherhood" in the local Wolof language. A young woman called Ndeye picks up a card from the deck. It is a picture of a pregnant woman carrying a large bag on her head.

Ndeye says this card means that a woman who is pregnant should not be carrying heavy weight. It is a risk. It can be bad for her and bad for the baby.

Empowering families

It is all part of a five-year health plan funded by USAID to helping improve family health in rural Senegal. 150 women were given cell phones to keep them informed of upcoming doctor’s appointments -- before, during and after pregnancy -- to remind them of vital immunizations for their babies and to invite them to different health talks at the Mbosse health clinic.

Deguène Fall is in charge of the community health programs for Plan International in Thiès, one of five nongovernmental organizations collaborating on the SMS program.

Fall says it has been an excellent project for areas where women have difficulty in accessing health clinics -- either financially or geographically.

Fall says that, before the cell phone project started, women only learned about health matters through discussions. But many felt there was too much talking and got bored. Fall says, when they came for their pre-natal consultations, doctors would write their next appointment down, but most of these women are illiterate. Even with immunizations, they would forget because they were out working in the field or too busy helping in the house. Fall says that now that they receive direct messages they do not usually forget.

Fatou Tine is a 25-year-old mother of four. She joined the text message program a year ago during her last pregnancy, but continues to attend meetings on other health topics, such as diarrhea, malaria prevention, HIV and family planning. Fatou is illiterate and so is her husband.

Tine says the project has been useful for her because her last pregnancy was a lot easier than the three before. Two days before every doctor’s appointment she got a text message. But, because she cannot read, the person she lives with helped her. Tine says that, in total, she received three messages during her pregnancy and four messages after to remind her about getting her baby vaccinated.

Health-care workers at the Mbosse clinic estimate about 95 percent of the women who receive texts do show up for their appointments. And, many also join in the regular health meetings, bringing their friends or husbands along.

Program helps to keep health cost down

The costs of visits range from about 20 cents for a child and 65 cents for an adult. Food and nutritional advice is 30 cents and medication is free. Although these prices are subsidized by the state, it can still be a lot in an area where a single visit to the doctor can mean half a day’s income.

The African Child Policy Fund ranks Senegal 13th in health expenditure, below Burkina Faso and Chad but well above Ghana. The Senegalese government spends slightly more than 12 percent of its annual budget on health. That is more than richer countries, such as South Africa, Morocco or Egypt, but still falls short of targets, set by African leaders to spend 15 percent of GDP (gross domestic product) on health before 2015.

David Mugawe, an executive director of the African Child Policy Fund, says traditional means of communication are being sidelined. Media is playing a big part in creating awareness and passing on information at a low cost. Mothers can share experiences and learn from each other.

Mugawe says fathers are also being targeted because they make many of the decisions at home. He says they are the breadwinners and have access to resources, so they need to be supportive of the mother by going to health centers with them, supporting the well-being of their children.

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